Patient Forms

Smith & Co. Dental Practitioners has several specific patient forms used at the practice. Please download and fill-out our Patient Registration Form. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Download Our Patient Registration Form (PDF)

Please download and fill-out our Medical History Form. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Download Our Medical History Form (PDF)

Please download and fill-out our HIPAA Consent Form. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Download Our HIPAA Consent Form (PDF)

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